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Biomedical subjects

Y Kawada

Publications and source records attributed to Y Kawada.

At least 199 records · Page 11Linked to original sources
PubMed1989

[Malignant melanoma of male urethra: a case report].

A case of male urethral melanoma is reported. A 85-year-old male with a 2-month history of progressive, severe obstructive urinary symptoms and bloody urethral discharge was referred to us after an unsuccessful management at a local doctor. Physical examination revealed an ill looking old man with no evidence of nevi or other cutaneous pigmentation looking like malignant melanoma. Neither palpable periurethral mass nor inguinal lymphadenopathy was noted. RUG showed an irregular shadow defect in bulbous urethral regions. In cystourethroscopy, a raised nodular reddish black lesion in the urethra without adjacent satellite lesions was found. Histologic examination revealed that the tumor was made up of closely spaced, anaplastic, spheroidal or polyhedal cells. Intracellular brown pigment was richly present, gave a negative reaction for iron, but stained black with Masson-Fontana's method. Further examination for evaluating metastases including bone scintigraphy, computer tomographic scan, chest X-ray film were negative. Due to his poor risk, radical operation such as cystourethrectomy might be undesirable. We performed TUR to relieve urethral obstruction, because the patient refused cystostomy. He died of wide spread metastases at 6 months after the operation. This case seems to be the second report in the Japanese literature.

Aged↗
PubMed1989

Sultamicillin in the treatment of urinary tract infections.

An open multicenter study was carried out to evaluate the efficacy and safety of sultamicillin in patients with urinary tract infections or gonococcal urethritis. 1) Sultamicillin (750-2250 mg/day) was administered for 3 d to 196 patients with acute uncomplicated cystitis. The most common dosage regimen was 375 mg three times daily. The results of treatment based on the combination of changes in symptoms, pyuria and bacteriuria were excellent in 66.8%, moderate in 30.6% and poor in 2.6% of cases. Of 203 strains isolated before treatment, 185 (91.1%) were eradicated. The eradication rate for E. coli, the most common pathogen (167 strains), was 92.2%. 2) In total, 368 patients with complicated urinary tract infections were treated with 750-2250 mg/d of sultamicillin for 5 d. The most common dosage regimens were 375 mg three times daily and 750 mg twice daily. The clinical results based on the combination of changes in pyuria and bacteriuria were excellent in 30.4%, moderate in 35.6% and poor in 34.0% of cases. Of 470 strains isolated before treatment, 352 (74.9%) were eradicated. The eradication rate achieved with high beta-lactamase-producing organisms (64.1%) was not significantly different from that achieved with low or non-producers (75.6%). 3) Sultamicillin (750-3000 mg/d) was administered to 367 male patients with gonococcal urethritis for 3 to 7 d. The eradication rate ranged from 92.3% with 750 mg/d to 100% with greater than or equal to 1500 mg/d. The effect of dose was particularly evident with the 27 strains of gonococci that had penicillinase activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

[A case of testicular tumor presenting as acute scrotum].

A case of teratoma of the testis presenting as sudden spontaneous hemorrhage without previous injury is described. A 25-year-old male was admitted with right scrotal pain and swelling. Though acute epididymitis or testicular torsion could not be neglected on physical examination, tumor-like echogram was obtained. High orchiectomy was performed subsequently. Macroscopically, testicular tumor with subcapsular hematoma was evident. Histopathological diagnosis was mature teratoma (pT1, No, Mo). The patient, after combined chemotherapy including cisplatin, vinblastine and peplomycin, is alive well without metastases for 15 months after operation.

Acute Disease↗
PubMed1989

[Blind-ending bifid ureter: report of a case].

A case of blind-ending bifid ureter is presented. A 65-year-old man was admitted with the complaint of dysuria. He had no past episode of left flank pain or pyelonephritis. Digital examination and urethrography suggested benign prostatic hypertrophy. Drip infusion pyelography showed an abnormal cavity at the lower portion of the left ureter. He was diagnosed as benign prostate hypertrophy and left blind-ending bifid ureter. During suprapubic prostatectomy, the bifid ureter was resectd. The related reports are reviewed in the Japanese literature.

Aged↗
PubMed1989

[Xanthogranulomatous pyelonephritis coexisting with fistula between ureter and sigmoid colon: a case report].

A 63-year-old woman with the complaints of left renal stone and fistula between left ureter and colon was transferred to our clinic by a local doctor. Anemia, gamma-globulinemia, and acceleration of ESR were detected by hematology on admission. Kidney-ureter-bladder X-ray and intravenous pyelography showed left non-functioning kidney with coral stone, and RP revealed a fistula between left ureter and sigmoid colon. She was operated by nephroureterectomy and fistulectomy. The resected kidney appeared pale and parenchyma was almost replaced by yellowish tissue and pus. Histologically, the lesion was confirmed to be xanthogranulomatous pyelonephritis. Meanwhile, the cause of the fistula was considered to be due to extending ureteritis and pelvic infection from the pyelonephritis. Postoperative course was satisfactory.

Female↗
PubMed1989

[A case of renal cell carcinoma with lung metastases successfully treated by interferon-beta].

A case of renal cell carcinoma with multiple lung metastases successfully treated with interferon (IFN) following nephrectomy is reported. A 46-year-old man consulted our institute complaining of left flank pain for 3 months on June 18, 1983. Macroscopic hematuria consisting of blood clot had also been found 1 week before. For a diagnosis of left renal carcinoma with multiple lung metastases, he was admitted. After total nephrectomy, 30 x 10(6) units per day of natural IFN-beta were administered intravenously every other day for 2 months (total dose; 269 x 10(6) units). One of the pulmonary lesions disappeared, but another increased in size and a new lesion was also found. Therefore, this trial was evaluated to be progression. Thereafter, he was treated with 600 mg/day of carmofur (HCFU) and was in a stable condition. As his lung lesions progressed at 11 months after nephrectomy, 9 x 10(6) units/day of recombinant IFN-beta were additionally administered 5 days a week for 4 weeks. When the treatment was completed (total dose; 180 x 10(6) units), the pulmonary lesions disappeared. The complete response lasted for 9 months. However, on May, 1985, bone metastasis to lumbar vertebra was found and he died on November 4, 1985 without any evidence of relapse at lung field.

Antineoplastic Agents↗
PubMed1989

[A case of retrovesical tumor].

A 53-year-old man was admitted with complaint of left lower abdominal pain. Retrovesical tumor was suggested after digital examination and imaging diagnosis. At operation, the encapsulated tumor occupied the retrovesical space, but was not adhered to the adjacent organs such as prostate, seminal vesicles, bladder and rectum. The entire tumor was successfully resected. Histopathological report revealed a mature teratoma. He is alive without recurrence at 1 year after operation. This is the second case of retrovesical teratoma in the Japanese literature.

Humans↗
PubMed1989

Changes in catecholamine level in hypotensive patients subjected to dialysis.

An increase in the long-term survival ratio of patients with chronic renal failure has led to an increase in constant hypotensive accidents and cases of hypotension attacks during hemodialysis in spite of no prior abnormal physical findings, leading to difficulty in maintaining further dialysis. Many investigators have examined the plasma noradrenalin (NA) levels in dialysis patients, but the relationship between blood pressure and the plasma catecholamine concentration remains unknown. In our time-course plasma catecholamine level measurements, no significant difference was observed between the pre- and post-hemodialysis period, but a comparison of the plasma catecholamine levels for respective time periods revealed that a decrease in plasma NA levels corresponded to a decrease in blood pressure 3 to 4 hours after the beginning of hemodialysis. Administration of amezinium, which was thought to increase the plasma NA level, succeeded in maintaining and facilitated maintenance of a favorable blood pressure. The plasma NA concentration was considered to be related to a reduction of blood pressure during hemodialysis.

Female↗
PubMed1989

[Intra-arterial chemotherapy with cisplatin in advanced urothelial cancer].

Thirty-two patients with advanced bladder cancer received intraarterial infusion of chemotherapy with cis-platin (CDDP). For twenty-one patients, the intraarterial infusion was carried out using Seldinger's method. On the other hand, for the eleven patients who were diagnosed as inoperable cases, the intraarterial infusion was carried out using the reservoir system. The mean regression in the size of the tumor was 64%, which was statistically superior to the mean regression in the intravenous administration group, was 45%. According to Shimosato's criteria, the pathological response was evaluated. Seven patients (22%) were detected as having more than grade III. On the other hand, among the intravenous administration group, only one case (11%) was detected as more than grade III. Following the intraarterial infusion of chemotherapy, subsequent surgical treatment was performed on 21 patients. Fourteen patients underwent the organ-preserving operation, either transurethral resection or segmental resection of the bladder, and seven patients underwent radical cystectomy. In seventeen patients (53%), there was no evidence of the disease. Especially, eleven patients (79%) who under went the organ-preserving operation had no evidence of the disease. The intraarterial infusion method of chemotherapy with CDDP showed a high response, both in terms of regression of tumor size and the pathological degeneration, compared to intravenous administration of CDDP. The subsequent surgical treatment following chemotherapy issues not only a better survival rate, but also makes possible preservation of organs.

Adult↗
PubMed1988

Long-term survival of a patient with Lutembacher's syndrome.

An elderly woman with Lutembacher's syndrome remained asymptomatic until the age of 55, when she was treated for exertional dyspnea with digitalis and diuretics. She died of gastrointestinal hemorrhage and hepatic failure at the age of 69. The autopsy revealed a large atrial septal defect and mitral stenosis without rheumatic changes. This patient is the oldest reported survivor of Lutembacher's syndrome with nonrheumatic mitral stenosis.

Aged↗
PubMed1988

[Clinical evaluation on an enzyme immunoassay kit for basic fetoprotein (BFP). (1) Clinical usefulness of BFP].

Clinical usefulness of a sandwich enzyme immunoassay kit for basic fetoprotein (BFP), which has been developed with two kinds of monoclonal anti-BFP by Nippon Kayaku Co., LTD., was evaluated on detection of BFP in the sera. Based on the consideration of BFP-positive rate under 5% in healthy donors and diagnostic efficiency for cancer, a BFP-concentration of 75ng/ml was used as the cut off value. BFP in the sera was positive in 3.5% of 368 healthy donors, 18.2% of 549 patients with benign diseases and 45.3% of 870 patients with cancer. High positive rates of 50 approximately 60% for the serum BFP were found in cancer of the liver, bile duct, pancreas, kidney, prostate, testis and ovary. In early cancer of the bile duct and urogenital organs, high BFP-positive rates beyond 46% were recognized. BFP values in 7 of 9 BFP-positive patients with urogenital cancer fell down to negative serum level after the radical operation. These results indicate that BFP is a tumor marker with widespread representation in cancer and contributes to serological diagnosis for cancer of digestive and urogenital systems, particularly for early cancer of these systems. Furthermore, it is suggested that BFP is useful for monitoring of cancer patients after surgery.

Adolescent↗
PubMed1988

[Clinical evaluation on an enzyme immunoassay kit for basic fetoprotein (BFP). (2) Comparison and combination of BFP with other tumor markers].

Comparison of basic fetoprotein (BFP) with 10 other tumor markers was made with sera from 549 patients with benign diseases and 870 patients with cancers, using BFP-EIA kit and commercial kits for others. BFP-positive rates higher than CEA or CA19-9 were found in various cancers except CEA in cancer of the colon, pancreas and lung, or CA19-9 in cancer of pancreas and bile duct. Furthermore, BFP showed higher positive rates in comparison with AFP in cancer of liver and testis, SLX(sialyl SSEA-1) or SCC in lung cancer and CA125 in uterine cancer. The correlation coefficient of BFP with other tumor markers except for SCC in lung cancer were low (below 0.262) in cancer and benign diseases. The combined assay of BFP with some other makers such as CEA in cancer of the digestive organ, lung, markers ovary and uterus, CA19-9 in cancer of the bile duct and lung, CA125 in ovarian cancer, AFP in cancer of the liver and testis, and PAP in prostatic cancer, showed an elevation of diagnostic efficiency compared with single assay. These results indicate that BFP is superior to other tumor markers for serological diagnosis of various cancer and also available for the combined assays.

Biomarkers, Tumor↗
PubMed1988

[A case report of non-specific granulomatous prostatitis: successful treatment with chlormadinone acetate].

A case of non-specific granulomatous prostatitis is presented. A 61-year-old male consulted a doctor with the chief complaint of dysuria. For suspicion of prostate cancer, he was referred to our hospital. A digital examination showed stony hard prostate gland which was asymmetrically enlarged to hen's egg size with an irregular surface. Since biopsy specimen from the prostate showed eosinophilic granulation without fibrinoid necrosis, the case was diagnosed as simple nonspecific granulomatous prostatitis. After oral administration of chlormadinone acetate (CMA), he showed a remarkable increase in urinary stream. The findings of urethrogram and prostatic sonogram demonstrated dramatic improvement. He has remained asymptomatic for 29 months without any further treatment. Therefore, CMA could be effective against granulomatous prostatitis.

Administration, Oral↗
PubMed1988

[Paget's disease of the scrotum].

We reported a case of Paget's disease of the scrotum, a rare disease in urological field. The patient had successful radical resection of the dermal tumor and scrotal plasty. Paget's disease has a low malignancy and its treatment is necessary as the same manner to scrotal cancer. Although most scrotal malignancies are squamous cell carcinoma, urologists should recognize this borderline disorder exactly such as in this case and treat patients with co-operation to the relative fields.

Aged↗
PubMed1988

[A case of renal cell carcinoma suspected of multilocular cystic nephroma].

A 52-year-old, healthy looking woman was referred for further evaluation of left renal mass, She had had a history of hematuria for ten years. Admission laboratory studies were within normal limits except for slight elevation of white blood cell count, c-reactive protein, blood sedimentation rate and immunosuppressive acidic protein. Retrograde pyelography demonstrated a large mass with ringed calcification in the middle lobe of the left kidney. The multiloculated mass was also confirmed by computed tomography and ultrasonography. Selective left renal arteriography showed stretched arteries and irregularity and tortuosity of the smaller vessels. Under a presumptive diagnosis of multilocular cystic nephroma or renal cell carcinoma, left radical nephrectomy was performed. In surgical specimen, many lobules were filled with serous fluid and clotted blood. Microscopic examination revealed that the lining of the cyst wall consisted of renal cell carcinoma cell. At present, 5 months after the operation, she is well without any signs or symptoms of recurrence.

Carcinoma, Renal Cell↗
PubMed1988

[A case of intrascrotal leiomyoma originating from tunica vaginalis].

A case of intrascrotal leiomyoma originating from tunica vaginalis is reported. The patient was a 63-year-old male who complained of painless tumor of the right scrotal contents. The tumor was surgically removed easily. The histological examination of the tumor revealed leiomyoma. Seven cases of intrascrotal leiomyoma reported in Japan were reviewed.

Genital Neoplasms, Male↗
PubMed1988

[Primary carcinoid tumor of the testis: a case report].

A case of pure, primary testicular carcinoid tumor in a 27-seven-year-old male is reported. The patient presented with a painless enlargement of the right testis but the serum markers for testicular cancer, including alpha-fetoprotein, beta-human chorionic gonadotropin and lactate dehydrogenase, were not elevated. Right orchiectomy was performed. Histologically, the tumor showed a typical appearance of carcinoid tumor. Further examinations such as barium studies, computed tomographic scan and Ga scintigraphy, showed no other lesions, and he received an adjuvant chemotherapy of cyclophosphamide, 5-fluorouracil and adriamycin. He is well and free from symptoms 17 months after surgery.

Adult↗